CE and PRICE

Course Description:
Integrative Restoration - iRest, also known as Yoga Nidra, is a multifaceted intervention developed by psychologist Richard Miller by adapting the ancient traditional Yoga Tantric practice of Yoga Nidra, a meditation rather than Hatha Yoga practice that integrates Eastern and Western aspects of psychology and psychotherapy. This adapted form, in its secular application, is called iRest. Since 2005, iRest has been used in a wide variety of clinical applications.

Background and Description

Integrative Restoration - iRest, also known as Yoga Nidra, is a multifaceted intervention with a strong mindfulness component developed by psychologist Richard Miller. A longtime yoga and meditation practitioner and teacher, Miller saw the potential for the application of Yoga Nidra in clinical, in addition to, spiritual contexts. He has adapted the ancient traditional Yoga Tantric practice of Yoga Nidra, a meditation rather than Hatha Yoga practice that integrates Eastern and Western aspects of psychology and psychotherapy. This adapted form, in its secular application, is called iRest. Beginning in March 2005, iRest has been used in a wide variety of clinical applications. Most notably, iRest has been the focus of pilot studies at the Deployment Health Clinical Center at Walter Reed Army Medical Hospital, Brooke Army Medical Center, and the Miami and Chicago VA Centers researching the impact of iRest with active duty and veterans returning from Iraq and Afghanistan warfronts suffering from Post Traumatic Stress Disorder (PTSD). See below for a listing of iRest research to treat a long list of other psychiatric and medical conditions.

Dr. Miller himself first encountered Yoga Nidra in 1970. He began teaching this practice several years later. In the 80s and 90s his teaching of Yoga Nidra gradually took the shape that is now being taught by the many practitioners he has trained. Today instruction in Yoga Nidra is offered at many spiritual centers and, as iRest, in many clinical settings throughout North America. For more about Dr. Miller and a description of his own initial experiences of Yoga Nidra that started him on his path, watch the following video.

Overview of iRest

iRest is grounded in the skill of paying close attention to present moment experience, or mindfulness. Inherent in this process is the cultivation of an attitude of acceptance, even welcoming, towards the experience of the moment, whatever it may be. See the following video for Dr. Miller’s own expression of this most fundamental spirit of iRest practice.

iRest is comprised of ten stages including: setting conscious intentions, creative visualization, mindfulness of a variety of human experiential domains such as body, breath, energy, emotions, cognitions and joy, and the resourceful strategy of shifting the focus of attention between opposites, then holding both opposites in mindful attention simultaneously. Lastly iRest introduces a practice that is perhaps unique in its use in the clinical context, that of turning to inquire into the nature of our own mind’s capacity to know, Awareness itself. The richly multifaceted iRest protocol can be taught both in a group context and in the course of individual psychotherapy.

Details of the iRest Therapeutic Protocol: Preliminary Steps

Whether taught to a group or individually, iRest is presented as a series of meditative skills and inquiries that are gradually developed through hands-on practice. Unlike other forms of mindfulness practice, iRest is often practiced while lying down, a posture that facilitates the deep relaxation that is the hallmark of this practice. As with other mindfulness practices, however, other postures can also be used. It is the cultivation of attention to, and inquiry into, present moment experience that is the central point.

The iRest protocol is taught in ten stages with three preliminary steps. The first preliminary step involves establishment of intention. Here the intention is set to fully engage in the practice during the current day’s iRest session. Any particular goals specific to the present session are also noted. The next step in an iRest session is referred to as the Heartfelt Desire. In this phase the practitioner opens to the deepest personal reasons that motivate him or her in life. These could include desires for healing or relief from suffering for oneself and/or others, yearning for understanding or wisdom, the cultivation of compassion, etc. The iRest approach to expressing one’s Heartfelt Desire is present-centered and sensually based. As the practitioner becomes aware of their own deepest yearnings emerging in the moment, they are phrased in thought in the present, as opposed to future, tense and imagined through one or more of the five physical senses as if happening in the present moment.

The third preliminary of the iRest protocol is the cultivation of an Inner Resource or safe place. Sometimes when exploring our direct experience, we open into challenging emotions, memories, or other kinds of difficult experiences. To assist at those times, the third phase of iRest practice is the cultivation of an individual inner resource of safety, security, well-being, and peace. The practitioner is guided to visualize a place, either from memory or using imagination that feels completely secure and safe to them. They are encouraged to expand their experience beyond just the visual sense to include sounds, aromas, or physical sensations that are present for them in their experience of their special place. Ultimately, this Inner Resource is located within one’s body as a felt-sense or inner experience of well-being that can be accessed at any time, no matter the circumstance one may be experiencing. This inner resource is revisited briefly at the beginning of each iRest session and is available as a refuge should difficult experiences become overwhelming or unmanageable, either during the formal iRest practice session or in daily life situations.

Stages One Through Four

Once intentions, Heartfelt Desires, and the remembrance of the Inner Resource of well-being have been established, the main body of an iRest practice session shifts to focused mindful inquiry into one of several domains of present moment experience. These domains, the first through fourth stages of iRest practice listed below, are taught in succession over a period of weeks.

1. Bodily sensations

2. Breath and subtle energetic sensations

3. Feelings and emotions

4. Thoughts, beliefs, imagery, and memory

Guided iRest sessions with each of these domains as the focus are taught in successive weekly sessions. Practice between sessions is assigned as homework, usually with a CD or Mp3 of a guided session as a support.

Particularly with bodily sensations, emotions, and beliefs, an additional strategy is taught to assist in dealing with challenging kinds of experiences that may arise. This strategy involves working with opposites. Using emotion as an example, the practitioner is asked to identify a particularly challenging emotion, one that causes them difficulty in their lives. If, for example, the practitioner chooses anger, they are then asked to determine for themselves what the opposite of anger would be. The answer may differ from one practitioner to another. For one person, the opposite of anger might be calmness, for another, acceptance, for a third, happiness. The practitioner is then instructed to begin their practice with intention for this period of practice, perhaps including their hopes relative to the target emotion, their Heartfelt Desire, and an experiential recollection of their Inner Resource. Next they are asked to bring to mind their target emotion, to allow it to emerge into their present moment experience. Further instruction is given to notice if the emotion is associated with any body sensations. After allowing anger to be present, attending mindfully to the experience in both mind and body, for some minutes, the instruction is given to let go of the anger and allow its opposite to be present. The opposite emotion is then experienced mindfully in the same manner for several minutes. Instruction is then given to return to the experience of anger. Instructions then alternate for some time between mindfulness of the target emotion and mindfulness of its opposite. Finally the instruction is given to hold both target and opposite in the mind at the same time.

Stages Five through Ten

The fifth phase involves connecting with our capacity for joy and, in particular, a deep layer of joy that rests within us always. In practice, this is accomplished by inviting the meditators to remember an especially joyful moment in their lives. As the memory comes into present moment experience, practitioners are guided to enhancement the experience by tuning into all sensory aspects of the event being remembered. Once the memory is strongly established along with its joyful emotional dimension, the memory is dropped leaving only the joy itself. This experience of pure joy is then allowed to expand throughout the body and into the space beyond bodily boundaries. Further instructions explore the relationship between joy and the one who is experiencing the joy, the location of joy, and finally the identity between joy and the underlying awareness itself.

The sixth stage involves connecting with the foundational feeling of being (as opposed to ‘doing’ or even ‘well-being’). This stage lays the foundation for further and more subtle developments as the mind, or witness, that which knows, is directed to look more pointedly at its own role in experience. The stages that ensue involve opening to the mind’s underlying spacious nature and an awareness of knowing pervading that space, the recognition of the insubstantiality and formlessness of mind and all that it experiences, and the recognition and letting go of the subtle thought that creates the sense of self-as-knower. Finally at the tenth stage, there dawns a way of being in the world in which these insights remain active in the background even while the ordinary world of distinctions, of apparent separation, of apparent solidity, of apparent self, unfolds.

For Dr. Miller’s own more detailed description of his protocol as applied in the context of PTSD treatment with soldiers returning from combat, watch the following video.

Research on iRest

Integrative Restoration is currently in the early stages of clinical research. Preliminary results suggest its usefulness in the treatment of PTSD and other forms of stress, as well as with a number of other psychiatric and medical situations. At present five completed studies have been completed, two of which have been published (see below). Completed or ongoing research studies (as of Summer, 2011) include testing iRest for the treatment of PTSD, insomnia, anxiety, stress (in colleges students and that experienced by patients suffering from multiple sclerosis and cancer), and chemical dependency relapse prevention. (See below for links to studies.) Research in the planning stages includes studies of iRest in the treatment of depression, chronic pain, traumatic brain injury, wellness and resiliency. A summary of the research with links to articles or preliminary reports can be found on the Integrative Restoration Institute’s website.

Further Information

Additional information about iRest/Yoga Nidra, including practice and training opportunities, as well as a list of qualified practitioners by region, can be found at Dr. Miller’s website, Integrative Restoration Institute.

For a preliminary report showing iRest’s effectiveness as a stategy for coping with stress among college students, see Eastman-Mueller H, Wilson T, Raynes D. (undated). The impact of iRest (Yoga Nidra) on college students. Columbia, MO: University of Missouri Student Health Center.

True/False Comprehension Quiz

iRest has been used to treat veterans returning from Iraq and Afghanistan who are suffering from PTSD.

TrueFalse

An element of iRest that is unusual for clinical applications is its incorporation of inquiry into the mind’s own capacity to know, or awareness.

TrueFalse

The preliminary practices for an iRest session include sitting in silence for 10 minutes and then using the breath to calm the mind.

TrueFalse

As of summer 2011, there are already dozens studies published in peer review journals showing iRest’s efficacy in various clinical contexts.

TrueFalse

In addition to veterans suffering from PTSD, iRest has been used with patients suffering from cancer and multiple sclerosis, college students, and homeless adults.

TrueFalse

At present there are no formal training programs for clinicians interested in learning to use iRest in their work with clients.

TrueFalse

At its deepest levels iRest develops into a transcendent way of being beyond our everyday life experience.

TrueFalse

An important element of the iRest protocol involves practitioners alternating between a target emotion or dysfunctional belief and its opposite, as established by the practitioner, and then holding both in the mind at the same time.